Obama administration let opponents define the Affordable Care Act

Introduction

When I saw the news coverage of White House health care adviser Jonathan Gruber’s remarks, in which he essentially called Americans stupid, I thought of the old saying, “With friends like that, who needs enemies?”

My next thought was, who’s being stupid here?

Gruber is an MIT health economist who worked on health care reform with both Mitt Romney, when he was governor of Massachusetts, and the Obama administration. In fact, he’s one of the reasons Obamacare looks so much like Romneycare, which Massachusetts lawmakers enacted in 2006.

During remarks he made at the Health Economists Conference at the University of Pennsylvania last year, Gruber claimed that the Obama administration and Congressional Democrats had no choice but to keep the public in the dark, and even mislead folks, about certain aspects of the reform bill as it was being written.

“The lack of transparency is a huge political advantage,” Gruber said. “And basically call it the stupidity of the American voter or whatever but basically that was really, really critical to getting this thing passed … ”

The White House hired Gruber in 2009 to help figure out the economic consequences of various health care proposals. Considering how inept the Democrats have been from the beginning in explaining how the reform law would benefit all of us — and why it was structured the way it was — I wouldn’t be the least bit surprised if we found out Gruber had also been hired to provide PR advice on how to sell the law to the public.

The Democrats’ strategy seems to have been to say as little as possible both about why reform was needed and how the final law would protect us from insurance industry abuses. Which, fortunately, it does. The problem is that most Americans have forgotten that it does — if they ever knew about it in the first place.

The reason I decided to advocate for reform after I quit my industry job in 2008 was because of those abuses. When he was running for president, Obama often cited those abuses, but after he became president, he and those around him seemed to forget the importance of constantly reminding the public why reform was necessary.

I got so frustrated at what appeared to be the absence of a communications strategy that I even went so far as to call the White House in the summer of 2009 to offer some unsolicited ideas. I was thanked for my interest but essentially told, “don’t worry, we’ve got this figured out.”

A few weeks later, I thought maybe that was true. In an address to a joint session of Congress on September 9, 2009, Obama did indeed remind the public about why reform was needed. He made a pretty compelling case. Here’s how he laid it out:

“ … But the problem that plagues the health care system is not just a problem for the uninsured. Those who do have insurance have never had less security and stability than they do today. More and more Americans worry that if you move, lose your job, or change your job, you’ll lose your health insurance too. More and more Americans pay their premiums, only to discover that their insurance company has dropped their coverage when they get sick, or won’t pay the full cost of care. It happens every day.

“What this plan will do is make the insurance you have work better for you,” he said. “Under this plan, it will be against the law for insurance companies to deny you coverage because of a pre-existing condition. As soon as I sign this bill, it will be against the law for insurance companies to drop your coverage when you get sick or water it down when you need it the most. They will no longer be able to place some arbitrary cap on the amount of coverage you can receive in a given year or in a lifetime … ”

He also cited a few other provisions of the plan that would provide Americans with “more security and more stability.”

I was encouraged because I thought the White House and Congressional reform advocates had once again realized what Americans needed to hear. I thought sure they would develop a communications strategy around those very points.

I thought wrong. The White House and Congressional Democrats let their opponents define the law. And those opponents did a superb job of developing and implementing a communications strategy to turn the public against what they decided to call “Obamacare.” That campaign has been so successful it has almost completely obscured the fact that the law actually benefits each and every one of us.

I can only guess that Obama’s team was persuaded that a lack of transparency, even about the good the law does, would be better than going to the trouble of trying to explain it.

Now that, in my opinion, is what’s really stupid.

Wendell Potter is the author of Deadly Spin: An Insurance Company Insider Speaks Out on How Corporate PR is Killing Health Care and Deceiving Americans and Obamacare: What’s in It for Me? What Everyone Needs to Know About the Affordable Care Act.